| NPI | 1992264493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 193) |
| Additional Taxonomies | 104100000X Social Worker (Licence: SC 8452) |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2019-03-14 |