| NPI | 1477020816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 161929) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 00667) |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2021-06-07 |