| NPI | 1699564195 |
|---|---|
| Former Name | TARA ENSIGN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA192295) |
| Enumeration Date | 2025-05-02 |
| Last Update Date | 2025-05-02 |