| NPI | 1285275800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.2204140) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2103004-TRNE) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.170923) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.162249) | |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2022-04-19 |