| NPI | 1790278158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.165364) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2021-03-10 |