| NPI | 1689909335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 4221-125) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 9182-120) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15583) | |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2024-01-25 |