| NPI | 1023577533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00587600) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00262400) |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC00587600) | |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2019-03-14 |