| NPI | 1780149468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-13173) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC-11684) |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2021-04-15 |