| NPI | 1891471777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA SUDRC-15344) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 39007BN) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2025-10-27 |