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 |