| NPI | 1972966745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.0004490) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH 101078) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.101078) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 101078) | |
| 101YP2500X Counselor, Professional (Licence: OH 0004490) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2023-02-08 |