| NPI | 1396305587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH CDCA150948) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2019-06-19 |