| NPI | 1366120024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 22042) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 10004484) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2025-09-13 |