| NPI | 1861091456 |
|---|---|
| Former Name | ALEXANDRIA NIZAMUTDINOVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.174133) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2022-12-08 |