| NPI | 1417412263 |
|---|---|
| Former Name | ELYSE HAWOUT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.170898) |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2019-12-05 |