| NPI | 1063987717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 2436) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 11675) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE P-1627) | |
| 101YP2500X Counselor Professional (Licence: NE 2604) | |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2020-07-14 |