| NPI | 1679064497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 405300000X Prevention Professional (Licence: OH OCPSA.161562) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2020-10-15 |