| NPI | 1043270093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00738) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 00738) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IA 00738) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2023-12-26 |