| NPI | 1710764279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA R1524500923) |
| Additional Taxonomies | 374700000X Technician (Licence: CA R1524500923) |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-12-22 |