| NPI | 1982775011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MA 4733) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 4733) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 445) | |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2023-01-16 |