| NPI | 1972165546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LPC-7322) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LCPC-8324) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2026-03-11 |