| NPI | 1942891718 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 40636)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Enumeration Date | 2021-02-03 | 
| Last Update Date | 2025-05-20 |