| NPI | 1336818996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC014036) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 1310) |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2024-04-29 |