| NPI | 1205164092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KS 2017) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 235) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2024-11-03 |