| NPI | 1487465225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 225C00000X Rehabilitation Counselor | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2025-01-20 |
| Last Update Date | 2025-01-20 |