| NPI | 1619611563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1489171122) |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-11-17 |