| NPI | 1629294970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 5699) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 371) |
| 251S00000X Community/Behavioral Health (Licence: OK 5699) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-09-05 |