| NPI | 1619667573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MD AC2837) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD AC2837) |
| 101YP2500X Counselor, Professional (Licence: MD AC2837) | |
| Enumeration Date | 2023-05-12 |
| Last Update Date | 2023-05-12 |