| NPI | 1790131977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0154441) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NM CTB20230967) |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2025-05-07 |