| NPI | 1639602519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-24084) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC 12358) |
| 101Y00000X Counselor (Licence: NC 12358) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2023-12-19 |