| NPI | 1689936759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SC 6295) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA APC002578) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2023-12-07 |