| NPI | 1164797429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161375) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C0800514) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2017-02-15 |