| NPI | 1760713499 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW10698) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.081078) | 
| 1041C0700X Social Worker, Clinical (Licence: OH I.1200249-SUPV) | |
| Enumeration Date | 2010-01-20 | 
| Last Update Date | 2022-07-15 |