NPI | 1770574618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0009305-SUPV) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.912921) |
Enumeration Date | 2005-10-31 |
Last Update Date | 2017-12-14 |