| NPI | 1902592454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002337) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC.0019083) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2023-12-19 |