| NPI | 1548764087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 121453) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 00036) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2021-02-25 |