| NPI | 1366958803 |
|---|---|
| Former Name | AMY MARIE HARRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.165543) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2018-07-11 |