| NPI | 1003232349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 014122) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068.0110093) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 151.0125503) | |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2023-11-27 |