| NPI | 1548742596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A022260316) | |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2025-09-18 |