| NPI | 1114644358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD 11110) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD 11110) |
| 101YP2500X Counselor Professional (Licence: MD 11110) | |
| Enumeration Date | 2022-10-27 |
| Last Update Date | 2022-10-27 |