| NPI | 1750909164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH E.2606368) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2026-02-04 |