| NPI | 1790020857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH C.0500894) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH ICDC.081141) |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2017-06-06 |