| NPI | 1174070288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16404-132) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 130186-121) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2022-03-21 |