| NPI | 1467812669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.0004045) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 892570) |
| 163W00000X Registered Nurse (Licence: OH 190216) | |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |