| NPI | 1679356505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.185877) |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2023-09-25 |