| NPI | 1568123768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LICDC.162594) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH C.2305140) |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2024-03-20 |