| NPI | 1912395500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO 0013607) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0001713) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2025-09-12 |