| NPI | 1235639253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401016071) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401224215) |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2024-05-17 |