| NPI | 1750743092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 70445) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: NY 307677) | |
| 208D00000X General Practice (Licence: NY 307677) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 63687) | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2024-07-17 |