| NPI | 1659020097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19627-130) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 12615-123) |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2025-10-03 |