| NPI | 1679878607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH S1903683) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC162091) |
| Enumeration Date | 2011-01-23 |
| Last Update Date | 2020-12-14 |