| NPI | 1134696081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.145860.MEDS-IV) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA170285) |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2019-08-22 |