NPI | 1073046140 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701007046) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710102818) |
Enumeration Date | 2017-04-06 |
Last Update Date | 2017-04-06 |