| NPI | 1912496134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00341100) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00759100) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2024-09-18 |