| NPI | 1265990337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 13740) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-18-0962-129152) |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2023-09-25 |