| NPI | 1609968072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 991605) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH c0500702) |
| 221700000X Art Therapist (Licence: OH 03-172) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-07-08 |