NPI | 1598338550 |
---|---|
Former Name | ANGELICA ELIZABETH NICHOLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 175747) |
Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 0001725) |
Enumeration Date | 2021-07-19 |
Last Update Date | 2023-12-04 |