| NPI | 1336651165 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.1700428) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.161065) | 
| 101YP2500X Counselor, Professional (Licence: OH E.1700428) | |
| Enumeration Date | 2017-11-02 | 
| Last Update Date | 2018-11-14 |