| NPI | 1578076923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-25011) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2019-03-11 |