| NPI | 1053989822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 14466-RAC) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2024-08-06 |