NPI | 1518505601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA LAC-5151) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA PLC10048) |
Enumeration Date | 2019-12-19 |
Last Update Date | 2025-10-01 |