| NPI | 1043766470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NH MH2012) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NH MH2012) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2020-07-10 |