| NPI | 1790144236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.1100046-SUPV) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH ICDC.101143-CS) |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2016-02-12 |