| NPI | 1902291339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LAC18827) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LASAC 13317) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2025-03-06 |