| 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 |