| NPI | 1306392139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 12850) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS 23085) |
| 101YP2500X Counselor, Professional (Licence: SC 7246) | |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2023-10-30 |