| NPI | 1932758802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC9153) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LC9153) |
| 101YP2500X Counselor, Professional (Licence: MD LC9153) | |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2024-05-21 |