NPI | 1306361456 |
---|---|
Former Name | CASSANDRA CHANNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.1901557) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161530) |
Enumeration Date | 2017-08-10 |
Last Update Date | 2023-12-27 |