| NPI | 1447558234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC12800) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LCA402) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA402) | |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2024-05-01 |