| NPI | 1245862374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |