| NPI | 1124287263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP1600X Counselor, Pastoral | |
| 101YS0200X Counselor, School | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2025-01-30 |