| NPI | 1396350328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver (Licence: OH RU386424) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH cdca173575) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2021-09-10 |