| NPI | 1043970510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: 21011733) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD 211011733) | |
| Enumeration Date | 2021-12-27 |
| Last Update Date | 2022-03-07 |