| NPI | 1164892667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL Lpc05240) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YP2500X Counselor, Professional (Licence: AL Lpc05240) | |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2024-10-22 |