| NPI | 1386114726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.174939) |
| Additional Taxonomies | 247200000X |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2021-03-09 |