| NPI | 1619688637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LA CIT-6003) |
| Additional Taxonomies | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: LA RN141382) |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2025-08-26 |