| NPI | 1619473881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MI 7501006415) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2023-05-16 |