| NPI | 1023615879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR T-21-813) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2021-08-23 |