| NPI | 1780043661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E0007226-SUPR) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 174492) |
| 101YP2500X Counselor, Professional (Licence: WV 2048) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH ICDC.151131-CS) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 18-402S) | |
| Enumeration Date | 2016-02-19 |
| Last Update Date | 2019-11-18 |