| NPI | 1649745340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 8781-125) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16627-132) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2023-06-08 |