| NPI | 1760843510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 923328) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S0006860) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2016-03-08 |