| NPI | 1184383556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC2918) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD AC0983) |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2021-12-14 |