| NPI | 1659119873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 102X00000X Poetry Therapist |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WV T-22-1923) | |
| 101YM0800X Counselor Mental Health | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 225XM0800X Occupational Therapist Mental Health | |
| 246RP1900X Technician, Pathology Phlebotomy | |
| 261QR0800X Clinic/Center Recovery Care | |
| Enumeration Date | 2024-07-20 |
| Last Update Date | 2024-07-20 |