| NPI | 1053507962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 658) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SC 3150) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2024-02-06 |