| NPI | 1376346411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 6861160) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID 6861160) |
| 101YP2500X Counselor, Professional (Licence: ID 6861160) | |
| Enumeration Date | 2025-03-31 |
| Last Update Date | 2025-03-31 |