| NPI | 1134424856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 5876) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 5876) |
| 101Y00000X Counselor (Licence: CO 5876) | |
| 106H00000X Marriage & Family Therapist (Licence: CO 5876) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO 495) | |
| Enumeration Date | 2011-01-12 |
| Last Update Date | 2017-01-03 |