| NPI | 1558147769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103K00000X Behavior Analyst | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC1900X Psychologist, Counseling | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 3747A0650X Technician, Attendant Care Provider (Licence: MO 291908) | |
| Enumeration Date | 2023-09-04 |
| Last Update Date | 2023-10-27 |