| NPI | 1790318681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-A-24014) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC CADC-21311) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC CADC-21311) | |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2020-03-04 |