| NPI | 1497331904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16377-131) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 131998-121) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2021-03-28 |