| NPI | 1215351747 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.014620) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 6336-125) | 
| 101Y00000X Counselor (Licence: WI 16331) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15975-131) | |
| Enumeration Date | 2014-02-04 | 
| Last Update Date | 2025-04-29 |