| NPI | 1114706322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0709024954) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0704016357) |
| Enumeration Date | 2023-09-26 |
| Last Update Date | 2023-09-26 |