| NPI | 1508222316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KY 252289) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 252289) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2021-05-11 |