| NPI | 1619503802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 281471) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 278546) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2023-12-13 |