| NPI | 1043720188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180013893) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 25619) |
| 101YM0800X Counselor Mental Health (Licence: IL 178.011041) | |
| 101YP2500X Counselor Professional (Licence: IL 178.011041) | |
| 225800000X Recreation Therapist (Licence: IL 49087) | |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2023-04-04 |