| NPI | 1659840361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14675) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 83-1529261) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 47-1172948) | |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2019-08-29 |