| NPI | 1912239930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16040-131) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2021-11-10 |