| NPI | 1477298222 |
|---|---|
| Former Name | MIRANDA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 180612) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.180612) |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2023-03-29 |