| NPI | 1104201748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC QS128183) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 21357) |
| 101YM0800X Counselor, Mental Health (Licence: NC 13905) | |
| 101YP2500X Counselor, Professional (Licence: NC 13905) | |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2022-03-22 |