| NPI | 1821548462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1234950716) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 500010BN) |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2019-03-13 |