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 |