| NPI | 1568124170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 18477) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2024-06-17 |