| NPI | 1023208410 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C3006) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 175348) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 02-11-101) | |
| 101YM0800X Counselor, Mental Health | |
| 101YM0800X Counselor, Mental Health (Licence: AL 3787) | |
| Enumeration Date | 2007-07-31 | 
| Last Update Date | 2024-04-19 |