| NPI | 1912710732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 7515) |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-01-27 |