| NPI | 1023479078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH17924) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL ADC0118802015) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2023-08-31 |