| NPI | 1699163931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C5023) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 18-R-46) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2024-02-07 |