| NPI | 1104640150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-05003) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6851114433) |
| Enumeration Date | 2024-11-14 |
| Last Update Date | 2024-11-14 |