| NPI | 1154011211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 185213) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2024-03-25 |