| NPI | 1639636269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 168812) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH 168812) |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2023-06-13 |