| NPI | 1558878611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.164850) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 00483) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2024-01-09 |