| NPI | 1962178160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 101Y00000X Counselor | |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2023-05-18 |