| NPI | 1316762776 |
|---|---|
| Former Name | VICTORIA MOODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.190675) |
| Enumeration Date | 2024-11-20 |
| Last Update Date | 2024-11-20 |