| NPI | 1962911552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C6641) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 22-02-10343) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-12-20 |