| NPI | 1659458941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH 6609) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E2562) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 923352) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2011-08-16 |