| NPI | 1104176148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CCMH0198781) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CAD0171001) |
| 103TR0400X Psychologist, Rehabilitation (Licence: NM 00165351) | |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2018-08-30 |