| NPI | 1619352366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 111071) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.0900530) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2015-07-23 |