| NPI | 1093188252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C3806) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 17-05-18) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2020-12-03 |