| NPI | 1568939171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 170001) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 166068) |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2019-03-26 |