NPI | 1457858342 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LCDCII.161621) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 165998) |
101YM0800X Counselor Mental Health (Licence: OH QMHS) | |
Enumeration Date | 2018-04-09 |
Last Update Date | 2019-12-17 |