| NPI | 1063754059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NM 0171051) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NM 0171051) |
| 101Y00000X Counselor (Licence: NM 0171051) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NM 0171051) | |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2015-03-21 |