| 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 |