NPI | 1366207417 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LAC-21154) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LASAC-15497) |
Enumeration Date | 2024-02-19 |
Last Update Date | 2024-05-07 |