| NPI | 1255915682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1577) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 26R503) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 162974) | |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2026-03-30 |