| NPI | 1053927376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 7784125) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 7784-125) |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2021-08-31 |