| NPI | 1114791225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 192957) |
| Additional Taxonomies | 172A00000X Driver (Licence: OH tz960955) |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2025-09-02 |