| NPI | 1801242052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 001173) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 003342) |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2025-03-02 |