| NPI | 1790329837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ID LPC-7844) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ID 5038794389) |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2021-08-03 |