| NPI | 1225530645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.163123) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 138) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |