| NPI | 1164071536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.2204361) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162278) | |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2023-09-11 |