| NPI | 1861954331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-26837) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: NC LCAS-26837) | |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2021-12-16 |