| NPI | 1679812036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA LCi11300418) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA B041201094) |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2020-12-15 |