| NPI | 1902441793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OR 26-QMHA-I-005397) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2026-01-13 |