| NPI | 1134667439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KS 3119) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KS 3022) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 795) | |
| 101YP2500X Counselor, Professional (Licence: KS 3119) | |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2023-10-03 |