| NPI | 1689275950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 11-R-14) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OR 24-QHMA-I-004329) |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2025-02-14 |