NPI | 1902285505 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1700465.SUPV) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161498) |
Enumeration Date | 2015-05-28 |
Last Update Date | 2019-11-21 |