| NPI | 1740727759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001596A) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401015237) |
| Enumeration Date | 2017-01-28 |
| Last Update Date | 2020-03-31 |