| NPI | 1639529167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH 0700435-SUP) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 131231) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2016-06-15 |