| NPI | 1073522579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VT 068-0000538) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VT 068-0000538) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VT 068-0000538) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2015-10-02 |