| NPI | 1104870302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005161) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 5195) |
| 101YM0800X Counselor, Mental Health (Licence: VA 0701005161) | |
| 101YM0800X Counselor, Mental Health (Licence: NC 5195) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 5195) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2012-07-31 |