| NPI | 1104408574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 27205) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A18028) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2022-08-31 |