NPI | 1154864320 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000886) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC.0019708) |
Enumeration Date | 2016-11-21 |
Last Update Date | 2023-08-18 |