| NPI | 1154183820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-72665) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT BBH-SWLC-LIC-81246) |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2025-08-29 |