| NPI | 1952969933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 170294) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2020-02-03 |