| NPI | 1942936232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 6549) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 001452) |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2025-07-29 |