| NPI | 1134572332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH C.2103407-TRNE) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH 004932) |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2021-08-31 |