| NPI | 1215446620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 161796) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LCDCIII.14173) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2022-07-21 |