| NPI | 1679522494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 10502) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 2980-125) |
| 101YM0800X Counselor, Mental Health (Licence: WI 2980-125) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2025-09-11 |