| NPI | 1689147290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180004843) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 24200) |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2019-01-07 |