| NPI | 1821770090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 20417-130) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-02-01 |