| NPI | 1881067759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: CO 2185) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO 2185) |
| 101YM0800X Counselor Mental Health (Licence: CO 2185) | |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2025-06-04 |