| NPI | 1083219018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0019565) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO LPCC.0017590) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002155) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2023-08-28 |