| NPI | 1922744143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0000395) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2024-07-15 |