| NPI | 1851976534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC.0018025) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO LPCC.0017337) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0001728) | |
| Enumeration Date | 2021-03-14 |
| Last Update Date | 2022-05-09 |