| NPI | 1073895256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT 1590LCPC) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1403LAC) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2012-03-02 |