| NPI | 1508225459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C 1300788) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 151783) |
| Enumeration Date | 2016-02-21 |
| Last Update Date | 2016-02-21 |