| NPI | 1568965564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.170503) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2019-05-09 |