NPI | 1487148276 |
---|---|
Former Name | DEIDRE LATOIA SOLOMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2406575) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161726) |
251S00000X | |
Enumeration Date | 2018-06-15 |
Last Update Date | 2024-10-11 |