| NPI | 1801347588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AK 123524) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AK 123524) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AK 3974) | |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2022-11-30 |