| NPI | 1659142446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1610) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 14073) |
| 101YM0800X Counselor, Mental Health (Licence: IA 129676) | |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2025-08-13 |