| NPI | 1861817611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 5730-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16152-132) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2024-11-06 |