NPI | 1669733168 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.188749) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: OH 67.000189) |
Enumeration Date | 2012-06-01 |
Last Update Date | 2024-06-06 |