| NPI | 1194055467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC # 933526) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH LSW # S.0011653) |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2022-01-17 |