| NPI | 1023659364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OR 22-QMHA-R-2828) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-24-4066) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2024-06-30 |