| NPI | 1710780713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NM CTB-2025-0079) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NM CTB20250079) |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-07-23 |