| NPI | 1790381671 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2024-04-23 |