| NPI | 1841707882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401017743) |
| 101Y00000X Counselor (Licence: MI 6401016097) | |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2023-09-01 |