| NPI | 1265498943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 90) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 1680) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2021-02-04 |