| NPI | 1629609425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 48279) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 42620) |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2021-06-10 |