| NPI | 1952177289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 28962A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 20466A) |
| Enumeration Date | 2023-11-28 |
| Last Update Date | 2025-10-02 |