| NPI | 1003208505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15891-132) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 129568-121) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2022-06-16 |