| 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 |