| NPI | 1144913815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC.0020039) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002419) |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2025-04-02 |