| NPI | 1588716146 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10491) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-11114) | 
| Enumeration Date | 2007-01-16 | 
| Last Update Date | 2025-09-11 |