| NPI | 1023407699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11989) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-20877) |
| 101YP2500X Counselor, Professional (Licence: NC 11989) | |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2021-03-08 |