| NPI | 1538646641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.168824) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 164882) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2019-04-01 |