| NPI | 1790178804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 20747) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 11392) |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2023-08-18 |