| NPI | 1871206904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MO 18571) |
| Additional Taxonomies | 246RM2200X Technician, Pathology Medical Laboratory |
| 246RP1900X Technician, Pathology Phlebotomy | |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2024-10-01 |