| NPI | 1629807250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 24935) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 24935) |
| 101YM0800X Counselor, Mental Health (Licence: IL 24935) | |
| Enumeration Date | 2024-07-31 |
| Last Update Date | 2025-05-31 |