| NPI | 1477054955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 168898) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 165626) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 168898) | |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2023-03-23 |