NPI | 1700451887 |
---|---|
Former Name | KATIE ISLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.176560) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH QMHS) |
Enumeration Date | 2021-05-21 |
Last Update Date | 2024-05-20 |