| NPI | 1154494300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 1055) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 1685) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 288) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2024-02-23 |