| NPI | 1104482371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2020-12-11 |