| NPI | 1184162018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: PA 9020) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 6516) |
| Enumeration Date | 2017-02-11 |
| Last Update Date | 2024-04-26 |