| NPI | 1679057590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 71767) |
| Additional Taxonomies | 174H00000X Health Educator |
| 246Y00000X Spec/Tech, Health Info | |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2019-06-11 |