| NPI | 1972166759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 08021-I) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2025-06-03 |