| NPI | 1609370535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 11948) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A11948) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 22296) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2021-02-16 |