NPI | 1003572173 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: IL 178.071588) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 37027) |
Enumeration Date | 2021-11-12 |
Last Update Date | 2021-11-12 |