| NPI | 1922179852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OH I 1500454 SUPV) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH I 1500454 SUPV) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH I 1500454 SUPV) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2016-08-16 |