| NPI | 1619331691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 9917) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 1196) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2026-07-16 |