| NPI | 1669983672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162215) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.162003) |
| 261QM0801X (Licence: OH QMHS) | |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2023-02-03 |