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 |