| NPI | 1831605948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA C4721214) |
| 101YP2500X Counselor, Professional (Licence: CA C4721214) | |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2022-11-14 |