| NPI | 1154553667 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11496) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MH11496) | 
| 101YP2500X Counselor, Professional (Licence: FL MH11496) | |
| Enumeration Date | 2009-08-17 | 
| Last Update Date | 2023-08-18 |