| NPI | 1003319971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH19283) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL MCAP0100136) |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2024-06-07 |