| NPI | 1265901821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002859) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CO LSW.0009925803) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2025-11-12 |