| NPI | 1457642126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5548-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15722-132) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2024-07-16 |