| NPI | 1023253283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 05-03-61) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 20-QMHA-I-03085) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2024-09-23 |