NPI | 1679954960 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 6273) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 130351) |
Enumeration Date | 2015-06-12 |
Last Update Date | 2023-12-19 |