| NPI | 1295081610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 96205) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA PT36366) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2025-09-18 |