| NPI | 1003225806 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH15334)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL ADC0105022015)  | 
| 101YP2500X Counselor, Professional (Licence: OR C9973)  | |
| Enumeration Date | 2014-08-05 | 
| Last Update Date | 2025-07-07 |