| NPI | 1649922691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 178.017312) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 34737) |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2022-01-21 |