| NPI | 1265162069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 24168) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2025-02-11 |