| NPI | 1760107536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 003536) |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2026-08-13 |