| NPI | 1013575562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA PC011111) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC0-11111) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2025-07-07 |