| NPI | 1720742885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19510-130) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health (Licence: 19510-130) | |
| 1041C0700X Social Worker, Clinical (Licence: WI 132742-121) | |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2023-06-08 |