NPI | 1134427131 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH9847) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701993981) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000199) | |
Enumeration Date | 2011-03-01 |
Last Update Date | 2024-07-01 |