| NPI | 1548922941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 178483) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2022-04-28 |