| NPI | 1275767600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401011318) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 1-04516) |
| 101YP2500X Counselor, Professional (Licence: MI 6401011318) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2025-07-31 |