| NPI | 1154074383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 15924) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 239288) |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2023-09-27 |