| NPI | 1811665052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 10005956) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2026-04-27 |