| NPI | 1558855254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: OHIO) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-07-03 |