| NPI | 1679086383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 166592) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 16278) |
| 101YM0800X Counselor, Mental Health (Licence: OH QMHS) | |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2018-11-20 |