| NPI | 1871163345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 175943) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 175943) |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2021-06-29 |