| NPI | 1871755736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 0013692) |
| 101YP2500X Counselor, Professional (Licence: OK 05112) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2025-10-20 |