| NPI | 1760985972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LCDCIII.162101) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 164479) |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2020-09-15 |