| NPI | 1629470323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 36) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO lcsw) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2021-04-02 |