| NPI | 1902599301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR T-22-1519) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OR 23-QMHP-R-2006) |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2023-06-05 |