NPI | 1114529294 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0016845) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC.0016845) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0001568) | |
Enumeration Date | 2020-11-12 |
Last Update Date | 2024-08-21 |