| NPI | 1669085536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.180638) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 175888) | |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2023-01-27 |