| NPI | 1225875198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID ACD-5046) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-07-09 |