| NPI | 1366030637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LCDCIII.162537) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2023-12-05 |