| NPI | 1801416466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-20-193) |
| Additional Taxonomies | 247000000X Technician, Health Information |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2020-06-30 |