| NPI | 1518498138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 151557) |
| Additional Taxonomies | 251S00000X (Licence: OH 121090) |
| 251S00000X (Licence: OH S1101669) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2019-12-31 |