| NPI | 1891220026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22593) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A12642) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2019-06-11 |