| NPI | 1972168243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA174244) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2020-09-18 |