| NPI | 1679205983 |
|---|---|
| Former Name | ASHLEY MACAUL BACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.185111) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.180930) |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2023-07-11 |