| NPI | 1598278780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH S.2004756) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.161823) |
| 1041C0700X Social Worker, Clinical (Licence: OH S.2004756) | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2021-09-10 |