| NPI | 1902310501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.1800578-SUPV) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E.1800578-SUPV) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 101Y00000X Counselor (Licence: OH E.1800578-SUPV) | |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2021-11-15 |