| NPI | 1124694534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2024022644) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2025-04-30 |