| NPI | 1659967966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 2783) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional (Licence: CO 0019321) | |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2024-09-12 |