| NPI | 1043916992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A17689) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 1650445) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-28114) | |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2023-02-02 |