| NPI | 1609452911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-31152) |
| Additional Taxonomies | 225600000X Dance Therapist (Licence: NY 001655) |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2025-09-23 |