| NPI | 1730680869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCII.162000) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2026-02-18 |