| NPI | 1700384906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 011414) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2019-01-31 |