| NPI | 1871277178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0709025933) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2025-01-29 |