| NPI | 1063009264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR T-19-599) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OR TG-21-039) |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2021-04-29 |