| NPI | 1215351747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.014620) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 16331) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15975-131) | |
| 101YP2500X Counselor, Professional (Licence: WI 6336-125) | |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2024-03-25 |