| NPI | 1154789113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PR 4342) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 8519) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2026-06-04 |