| NPI | 1609461052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.180046) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.175778) |
| 175T00000X Peer Specialist (Licence: OH APS.002278) | |
| 251S00000X (Licence: OH CDCA.175778) | |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2022-03-22 |