| NPI | 1093172264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL ADC01153-2015) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL 18067) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2022-09-14 |