| NPI | 1609406826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS25754) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A15447) |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2022-07-18 |