| NPI | 1114899069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCSW-LIC-80829) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-63795) |
| Enumeration Date | 2025-09-20 |
| Last Update Date | 2025-09-20 |