| NPI | 1497118863 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LICDC.923255) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH S-0013981) | 
| Enumeration Date | 2016-04-01 | 
| Last Update Date | 2024-05-06 |