| NPI | 1003486903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 171m00000x) |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2022-05-20 |