| NPI | 1336683986 |
|---|---|
| Former Name | ERIN FORTNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1901031) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161709) |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2019-01-30 |