| NPI | 1871092114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH E.2001702) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 101096) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2020-11-04 |