| NPI | 1922517283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 2391) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 100803) |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2024-01-31 |