| NPI | 1902046220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 16-R-26) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 25-QHMA-I005194) |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2025-11-13 |