| NPI | 1164296687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA R1537371123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1537371123) |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2026-05-26 |