| NPI | 1528273380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH 1.0010307) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IN F16510) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 071017) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |