| NPI | 1710469408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 4689) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 1374) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1834) | |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2020-12-01 |