NPI | 1346512878 |
---|---|
Former Name | DIANNA SUE PENNA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I. 1600796) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161433) |
Enumeration Date | 2012-01-30 |
Last Update Date | 2017-05-03 |