| NPI | 1255710570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 111024) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C.2003026) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 405300000X Prevention Professional (Licence: OH OCPC.1222) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2020-11-23 |