| NPI | 1235745209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 9397) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA 265839) |
| 101YP2500X Counselor, Professional (Licence: PA PC006948) | |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-09-16 |