| NPI | 1912503806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA R1409961120) |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2020-12-08 |