| NPI | 1265567234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 070026) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: OH 51168) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-07-08 |