| NPI | 1114417334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI 2-01594) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LCDCIII.161537) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2020-01-07 |