| NPI | 1609289859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO .0019390) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO NLC103554) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2023-07-10 |