| NPI | 1851829220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC009926) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 101073) |
| 101Y00000X Counselor (Licence: OH 1400344) | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2018-08-01 |