| NPI | 1063059574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AL C3415A) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL C3415A) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL C3415A) | |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-04 |