| NPI | 1548729544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-25211) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 5584) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2023-01-26 |