NPI | 1124465216 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 6233) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 36-2709982) |
101YP2500X Counselor, Professional (Licence: WI 6233) | |
Enumeration Date | 2013-05-29 |
Last Update Date | 2020-06-09 |