| NPI | 1265258602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 293001) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 284120) |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2025-08-21 |