| NPI | 1902441793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 171M00000X Case Manager/Care Coordinator (Licence: OR 25-QMHA-R-6763) | |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2025-03-20 |