| NPI | 1104142272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.002249) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 14143) |
| 101YP2500X Counselor, Professional (Licence: IL 180.002249) | |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2022-11-30 |