| NPI | 1962868505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 17510) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-28067) | |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2022-08-11 |