| NPI | 1104279256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: 1104279256) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101Y00000X Counselor (Licence: NV 1104279256) | |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2025-11-13 |