| NPI | 1679939151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OH I.1201373.SUPV) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCD.120862) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |