| NPI | 1992800684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000072) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VT 0470000643) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2025-09-11 |