| NPI | 1154706315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OH S0031268) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 131062) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-07-31 |