| NPI | 1003532375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000011) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: CT 66) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2022-10-18 |