| NPI | 1407595515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MA 21922) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 227216) |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2023-12-20 |