| NPI | 1679146591 |
|---|---|
| Other Name | NA NA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NA) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-07-19 |