| NPI | 1700474384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CA 12183) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 11400) |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2025-09-30 |