| NPI | 1649766460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NJ 37AC00467900) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NJ 37LC00271900) |
| Enumeration Date | 2018-07-04 |
| Last Update Date | 2022-07-18 |