| NPI | 1679025134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16249-131) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 131929-121) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2020-07-10 |