| NPI | 1679089189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LASAC-15445) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2022-10-03 |