| NPI | 1861909343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 373H00000X Day Training/Habilitation Specialist | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 8759) | |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2026-08-21 |