| NPI | 1053472944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2573) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 1388) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 527) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2016-02-10 |