| NPI | 1841930344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 22743) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CA 49-02) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2024-10-15 |