| NPI | 1912647264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH S.2608258) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.184373) |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2026-06-23 |