| NPI | 1104353069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: LA 5894) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional (Licence: LA 5894) | |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2017-05-22 |