| NPI | 1215765334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS 01857) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KS 01857) |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-22 |