| NPI | 1265563258 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A2008005)  | 
| Additional Taxonomies | 225400000X Rehabilitation Practitioner | 
| Enumeration Date | 2007-03-08 | 
| Last Update Date | 2023-06-08 |