| NPI | 1063729028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12016) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP4654) |
| 101YM0800X Counselor, Mental Health (Licence: FL IMH7801) | |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2013-12-30 |