| NPI | 1518433119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.175957.MEDS-IV) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 163250) |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2021-03-17 |