| NPI | 1710615117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 923364) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S0022964) |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2022-08-12 |