| NPI | 1659040392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 181523) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 177627) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2022-08-23 |