| NPI | 1740702828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.1901743-TRNE) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH RA.161588) |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2019-06-03 |