| NPI | 1619476959 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 161167)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: OH w.1600012)  | 
| Enumeration Date | 2018-02-01 | 
| Last Update Date | 2023-10-30 |