| NPI | 1205583234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 10223) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID LPC-7578) |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2024-07-19 |