| NPI | 1114270915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 10343) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-2653) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2653-A) | |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2021-09-01 |