| NPI | 1467178053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LGP13227) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD ADT2497) |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2023-02-01 |