| NPI | 1104365196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180013871) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 31986) |
| 101YP2500X Counselor, Professional (Licence: IL 178.009904) | |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2023-11-08 |