| NPI | 1073603437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-15542) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 905) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-15036) | |
| 101YM0800X Counselor, Mental Health (Licence: NE 3011) | |
| 101YM0800X Counselor, Mental Health (Licence: NE 436) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-12-16 |