| NPI | 1659899631 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 8748-125)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: C.1400546)  | 
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2017-08-30 | 
| Last Update Date | 2024-03-27 |