| NPI | 1740080357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2025039421) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 01277-P) |
| Enumeration Date | 2025-03-14 |
| Last Update Date | 2025-09-29 |