| NPI | 1376675595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162003) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.113413.MEDS-IV) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2024-08-22 |