| NPI | 1912204173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 3585) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 1989) |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2024-06-03 |