NPI | 1043759582 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001672) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 16107) |
Enumeration Date | 2017-02-16 |
Last Update Date | 2021-05-10 |