| NPI | 1023536463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 4405) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 1267) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2021-02-02 |