| NPI | 1821740770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 21099) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IA 113535) |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2024-09-04 |