| NPI | 1063071041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NM CTB20220688) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NM CSA0204571) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2022-09-27 |