| NPI | 1508627548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19611-130) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 7219-226) |
| 101YP2500X Counselor, Professional (Licence: WI 11457-125) | |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2024-12-06 |