| NPI | 1932860863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 18329) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2025-10-22 |