| NPI | 1164248340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 175T00000X Peer Specialist | |
| 225800000X Recreation Therapist | |
| 226000000X Recreational Therapist Assistant | |
| 374K00000X | |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2024-12-03 |