| NPI | 1720572688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1441210821) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2021-12-10 |