| NPI | 1063906782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 7821-125) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 18179-130) |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2025-06-20 |