| NPI | 1174957963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR R8160) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: professionallicense) |
| 101YP2500X Counselor, Professional (Licence: ID 8378) | |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2023-06-26 |