NPI | 1376026559 |
---|---|
Former Name | DEBRA JOY MAHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.168408) |
Additional Taxonomies | 104100000X Social Worker (Licence: OH W1400027) |
Enumeration Date | 2018-09-13 |
Last Update Date | 2018-11-29 |