| NPI | 1679843189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 10674) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 0011344) |
| 101Y00000X Counselor (Licence: CO 12274) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 325) | |
| Enumeration Date | 2012-01-01 |
| Last Update Date | 2023-11-26 |