| NPI | 1659895977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 25441) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2019-06-26 |