| NPI | 1063973824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 2237) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 1064) |
| 1041C0700X Social Worker, Clinical (Licence: NH 2237) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2021-03-13 |