| NPI | 1548772254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 140171) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH QMHS3) |
| 175T00000X Peer Specialist (Licence: OH PRS.00395) | |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2018-11-20 |