| NPI | 1124512959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 170717) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 167119) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2019-06-17 |