| NPI | 1841710282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 123120) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 123120) |
| 101YP2500X Counselor Professional (Licence: CA 123120) | |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-07-21 |