| NPI | 1104224310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0190971) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0099011) |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2021-08-23 |