| NPI | 1962980888 |
|---|---|
| Former Name | SAMANTHA JO BROCKMEYER |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH S.2005043) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.169590) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2020-07-13 |