| NPI | 1164974259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH w1600019) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 160570) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |