| NPI | 1003301888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 692) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 90) |
| 101YP2500X Counselor, Professional (Licence: KS 882) | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2022-07-27 |