| NPI | 1619421229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH E0700924) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 965611) |
| 163W00000X Registered Nurse (Licence: OH RN187095) | |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |