| NPI | 1174371645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 16238) |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2025-04-30 |