| NPI | 1710515853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0710102033) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0704006290) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2022-12-09 |