| NPI | 1922534023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401018335) |
| Additional Taxonomies | 101Y00000X Counselor |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2021-09-03 |