| NPI | 1194286211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH C.2103680) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.169544) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OH C.2103680) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2022-09-06 |