| NPI | 1689289126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 106S00000X Behavior Technician | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2021-04-14 |