| NPI | 1639633878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OH 000673) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 165991) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2021-05-07 |