| NPI | 1043564453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 1102244) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 5043) |
| 101Y00000X Counselor (Licence: SC 5043) | |
| 101YM0800X Counselor, Mental Health (Licence: SC 5043) | |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2025-09-04 |