| NPI | 1619608874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA PC013733) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: PA PC013733) |
| 101YS0200X Counselor School (Licence: PA PC013733) | |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2022-06-20 |