| NPI | 1780748376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OH I.0007876-SUPV) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH 10007876) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CS.00000349) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2022-07-15 |