| NPI | 1619532298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA t19063) | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2022-08-11 |