NPI | 1316408800 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0016530) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACA.0007116) |
Enumeration Date | 2019-03-27 |
Last Update Date | 2021-01-11 |