| NPI | 1700392032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.2002543) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII161930) |
| Enumeration Date | 2017-12-22 |
| Last Update Date | 2022-09-26 |