| NPI | 1689968521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1827) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 60547640) |
| 101YP2500X Counselor, Professional (Licence: MN CC03786) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-15029) | |
| 174400000X Specialist | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2025-11-24 |