| NPI | 1972018265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710103166) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701010745) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2024-11-20 |