| NPI | 1336615004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 8788) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2021-02-16 |