| NPI | 1538807367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19709-130) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 7110-226) |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2023-03-13 |