| NPI | 1821693375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 19500) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 1121023) |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2025-07-29 |