| NPI | 1134678121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-004565) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: 57253) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 18049) | |
| Enumeration Date | 2016-10-01 |
| Last Update Date | 2022-07-21 |