NPI | 1962068577 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180015161) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 36495) |
Enumeration Date | 2019-05-20 |
Last Update Date | 2024-01-09 |