NPI | 1023545761 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0016139) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO NLC.0106710) |
Enumeration Date | 2017-05-12 |
Last Update Date | 2023-11-09 |