| NPI | 1245838549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 149.025438) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 150.103960) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 35677) | |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2023-11-06 |