| NPI | 1316536063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KY 98443) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LCDCIII.162430) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.174239) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: WV 98443) | |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2025-06-12 |