| NPI | 1275130452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 37790) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 106S00000X Behavior Technician | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2023-01-17 |