| NPI | 1790235091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161531) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C.1400434) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2018-12-26 |