| NPI | 1053682658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1171) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1054) |
| 101YP2500X Counselor, Professional (Licence: NE 2063) | |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2017-01-19 |