| NPI | 1154895365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-25533) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 2323) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2022-06-29 |