| NPI | 1033705090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C7416) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR R6795) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 20-R-32) | |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2024-05-31 |