| NPI | 1003180522 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 5349-125) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16211-132) | 
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2012-03-01 | 
| Last Update Date | 2023-04-05 |