| NPI | 1629533716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC007629) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 8912) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA CAADC8912) | |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2021-06-10 |