| NPI | 1053713354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OR C3321) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 13-R-37) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2023-07-27 |