| NPI | 1376236489 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional | 
| 106S00000X Behavior Technician | |
| Enumeration Date | 2023-06-02 | 
| Last Update Date | 2025-02-15 |