| NPI | 1154784478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: OH 0016345) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: OH 0016345) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2023-05-22 |