| NPI | 1063498087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 1191121) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health (Licence: WI 1114-123) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2025-01-27 |