| NPI | 1962105601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 11405) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2023-05-04 |