| NPI | 1508931296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 944072) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: OH I7005) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2016-07-08 |