| NPI | 1255198370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 23129) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA t23129) |
| 101YM0800X Counselor, Mental Health (Licence: IA 125637) | |
| Enumeration Date | 2024-03-05 |
| Last Update Date | 2024-04-24 |