| NPI | 1366091092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA181590) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 0001422) |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2022-12-19 |