| NPI | 1508354044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2023-07-05 |