| NPI | 1093390510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 138854) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 138854) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-16 |
| Last Update Date | 2024-02-28 |