| NPI | 1609928688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IA 00417) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2025-09-11 |