| NPI | 1053685313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-15138) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-08192T) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2025-01-11 |