| NPI | 1639887813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR R12184) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR G-25-07-1044) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2025-11-05 |