| NPI | 1164290169 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1531031023) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA R1531031023) | 
| Enumeration Date | 2023-12-19 | 
| Last Update Date | 2024-06-12 |