| NPI | 1063838019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.010785) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180.010785) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 180.010785) | |
| 101YP2500X Counselor, Professional (Licence: IL 180.010785) | |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2019-10-10 |