| NPI | 1083972566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC CRC #00114192) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2153) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA c0232) | |
| 101YM0800X Counselor, Mental Health (Licence: GA LPC009729) | |
| 101YM0800X Counselor, Mental Health (Licence: NC 8904) | |
| 101YM0800X Counselor, Mental Health (Licence: NC A8904) | |
| 101YP2500X Counselor, Professional (Licence: GA LPC009729) | |
| 101YP2500X Counselor, Professional (Licence: NC 8904) | |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2021-03-05 |