| NPI | 1093055113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 11236) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA 13251) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 383) | |
| Enumeration Date | 2013-02-27 |
| Last Update Date | 2023-12-01 |