| NPI | 1548746605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 16081) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-21224) |
| 101YP2500X Counselor, Professional (Licence: NC A16081) | |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2022-08-12 |