| NPI | 1902582273 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 93-2018402)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD 932018402)  | 
| Enumeration Date | 2023-06-22 | 
| Last Update Date | 2023-06-22 |