| NPI | 1588205975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0017917) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACD.0002571) |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2025-03-26 |