NPI | 1649864711 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC013516) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 15734) |
Enumeration Date | 2021-03-01 |
Last Update Date | 2021-08-26 |