| NPI | 1972233245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY CDCA.179945) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH 2022) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2022-06-10 |