| NPI | 1235782004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 170841) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2022-05-04 |