| NPI | 1710395330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3502-A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P013484) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2022-10-19 |