| NPI | 1255006128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180013566) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 34836) |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2024-02-26 |