| NPI | 1194293290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 8131-125) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 4213-226) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18682-130) | |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2024-03-26 |