| NPI | 1104293299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 009938) |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC01096000) | |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2025-04-30 |