| NPI | 1689411324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.138775.MEDS-IV) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2024-07-16 |