| NPI | 1104653211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPCC.0021476) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ADDC.0000435) |
| Enumeration Date | 2024-09-14 |
| Last Update Date | 2024-09-14 |