| NPI | 1467130252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 186126) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 182543) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2023-12-20 |