| NPI | 1831541226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0012493) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0007959) |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2022-02-07 |