| NPI | 1639637333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710103685) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0711000491) |
| 251C00000X Day Training, Developmentally Disabled Services | |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2022-05-19 |