| NPI | 1366069783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.192121) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MA061664) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2025-08-19 |