| 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 |