| NPI | 1164910451 |
|---|---|
| Former Name | THERESE ANNE LORSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA166669) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |