| NPI | 1124504089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA RT1453390826) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2026-09-17 |