| NPI | 1750902243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ 15159) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 15159) |
| 101YP2500X Counselor, Professional (Licence: AZ 770887) | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2023-01-25 |