| NPI | 1104059443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1396) |
| 101YP2500X Counselor, Professional (Licence: NC 7485) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2022-02-14 |