| NPI | 1700641404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH cdca.193597) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2024-02-21 |
| Last Update Date | 2026-01-16 |