| NPI | 1063305407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2025-06-03 |
| Last Update Date | 2025-06-03 |