| NPI | 1093365892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA r1492971222) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 17010) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2025-05-21 |