| NPI | 1023204427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 11013043-6004) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5376) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH10492) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 27771) | |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2019-02-11 |