| NPI | 1467948844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 3215) |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-09-07 |