| NPI | 1669122875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 266313) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 261802) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2022-09-12 |