| NPI | 1134187503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OR C0054) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR C054) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 941098) | |
| 101YP2500X Counselor Professional (Licence: OR C0054) | |
| 106H00000X Marriage & Family Therapist (Licence: CA HFC 22934) | |
| 106H00000X Marriage & Family Therapist (Licence: OR T0089) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2014-04-11 |