| NPI | 1194178467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH ICDC101019) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH 1440395) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2018-03-17 |