| NPI | 1538787411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.111018) |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2024-04-18 |