| NPI | 1104708734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 22515) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P022105) |
| Enumeration Date | 2025-07-24 |
| Last Update Date | 2026-03-16 |