| NPI | 1467294108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-29897) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P021279) |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2026-06-29 |