| NPI | 1649507500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH E3772) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S15369) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 131078) | |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2019-09-17 |