NPI | 1154608164 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 6213) |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 1302) | |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2011-11-05 |
Last Update Date | 2020-09-16 |