NPI | 1588461826 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 296342) |
Additional Taxonomies | 175T00000X Peer Specialist |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
324500000X Substance Abuse Rehabilitation Facility | |
Enumeration Date | 2025-02-25 |
Last Update Date | 2025-02-25 |