| NPI | 1033694062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 17273) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-66377) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2024-02-14 |