| NPI | 1912510405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701009614) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000645) |
| 251S00000X | |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2024-03-07 |