| NPI | 1649846437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601002195) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-05156) |
| 101Y00000X Counselor (Licence: MI 6451022092) | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2024-10-15 |