| NPI | 1962918649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 6896-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17755-130) |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2022-07-06 |