| NPI | 1770263816 |
|---|---|
| Former Name | HEATHER BROCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 190786) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2025-06-12 |