| NPI | 1720753668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CTE-2025-0851) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CTE-2025-0196) |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2026-07-09 |