NPI | 1275226169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-21815) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LAC-21815) |
Enumeration Date | 2023-05-29 |
Last Update Date | 2023-05-29 |