| NPI | 1124591797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10130) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AZ LMSW-13175) |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2019-01-07 |