NPI | 1295198737 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN 109056) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.1683216) |
Enumeration Date | 2016-04-01 |
Last Update Date | 2018-10-24 |