| NPI | 1730822693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 5295) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19804-130) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2022-11-14 |