| NPI | 1811404502 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 161591)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: OH 1701620)  | 
| Enumeration Date | 2018-01-04 | 
| Last Update Date | 2018-01-04 |