| NPI | 1972101871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 00887-T) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS 3633) |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-15 |