| NPI | 1669254751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 178.019144) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 25645) |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-10-16 |