| NPI | 1144367558 |
|---|---|
| Former Name | MICKI S GLASSBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.0003727-SUPV) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 991766) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2008-07-24 |