| NPI | 1134337645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC15016) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 16602) |
| 101YP2500X Counselor Professional (Licence: IL 180004235) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2024-07-10 |