| NPI | 1104194380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0024043) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002759) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC.0020916) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 7395) | |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2026-07-21 |