| NPI | 1568902138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401017340) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401017340) |
| 101Y00000X Counselor (Licence: OH C.0900232) | |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2025-08-20 |