| NPI | 1144603895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT LCPC-LIC-19620) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT LAC-LAC-LIC-4511) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2017-04-19 |