| NPI | 1053769638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-54916) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT LAC-LAC-LIC-4219) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2023-08-08 |