| NPI | 1912465717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCII.161783) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 00981) |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2024-04-01 |