| NPI | 1225557580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 166824) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 358) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2018-09-11 |