| NPI | 1871651893 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA PC002697) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC002697) | 
| Enumeration Date | 2006-12-04 | 
| Last Update Date | 2025-09-11 |