NPI | 1154801512 |
---|---|
Former Name | MANDIE LEE MATTHEWS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.167863) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
175T00000X Peer Specialist (Licence: OH APS.003729) | |
Enumeration Date | 2018-08-15 |
Last Update Date | 2025-06-18 |