| NPI | 1851163554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16497) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 12483-123) |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2025-08-07 |