| NPI | 1043701550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.015985) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 37769) |
| 101YP2500X Counselor, Professional (Licence: NC 13837) | |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2024-06-06 |