| NPI | 1962903088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LICDC.162870) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH S.2410778) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2025-07-31 |