| NPI | 1316656622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN283974) |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2022-11-16 |