| NPI | 1871247551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA R1457610222) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2023-01-10 |