| NPI | 1396350088 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH E.2203017)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2002708)  | 
| Enumeration Date | 2020-09-10 | 
| Last Update Date | 2023-09-14 |