| NPI | 1902505068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL LPC05327) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AL ALC04319) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL ADC-1092) | |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2024-07-26 |