| NPI | 1043803398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: LA 8454) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LA LAC-5093) |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2021-07-13 |