| NPI | 1154854651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0019611) |
| Additional Taxonomies | 172A00000X Driver |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002928) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2026-04-22 |