| NPI | 1164281036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 29703) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A19912) |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-05-10 |