| NPI | 1568773364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN.080934) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH W.0800082) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 080306) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |