| NPI | 1518492057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 20358-130) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2024-04-02 |