| NPI | 1649892746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA177316) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2021-07-26 |