| NPI | 1700648334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.186835) |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-01-29 |