| NPI | 1891248357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701008028) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NY 009120-1) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710103071) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000412) | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2020-04-29 |