| NPI | 1770055808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: 18-56186) |
| Enumeration Date | 2018-12-31 |
| Last Update Date | 2024-12-04 |