| NPI | 1609387638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E1700396) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC161651) |
| 101YM0800X Counselor, Mental Health (Licence: OH E1700396) | |
| 261QC1800X Clinic/Center, Corporate Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2019-07-18 |