| NPI | 1255840237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 161382) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 102672) |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2022-07-21 |