| NPI | 1376384453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LAAC-08059T) |
| Additional Taxonomies | 172A00000X Driver |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2026-08-28 |