| NPI | 1114639879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00356800) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 37AC00808500) |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2025-03-04 |