| NPI | 1750821039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.161510) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 150837.MEDS-IV) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-11-29 |