| NPI | 1205565611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.162757) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH 2022) |
| 101YM0800X Counselor, Mental Health (Licence: OH QMHS) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OH 2022) | |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2024-09-24 |