| NPI | 1922568138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.169029) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2024-03-04 |