| NPI | 1710437314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-19233) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT BBH-PCLC-LIC-4852) |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2024-03-31 |