| NPI | 1457941692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBHLCPCLIC57437) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBHLACLIC62582) |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2024-05-10 |