| NPI | 1295397040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.168281) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.328476) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |