| NPI | 1205666336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1143) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P022047) |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2026-07-01 |