| NPI | 1962138065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 20197) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2025-01-30 |