| NPI | 1710199153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: OH 2627) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH E0003990) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 852160) | |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2025-09-11 |