| NPI | 1538688692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401224898) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2026-04-17 |