| NPI | 1174232631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC.0019571) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002110) |
| 101Y00000X Counselor (Licence: CO LPCC.0018410) | |
| Enumeration Date | 2022-11-23 |
| Last Update Date | 2023-08-14 |