| NPI | 1124707617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH cdca.190212) |
| Additional Taxonomies | 174400000X Specialist |
| 175T00000X Peer Specialist (Licence: OH aps.005502) | |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2025-07-07 |