| NPI | 1154707420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 12626) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 21683) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 20965) | |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2022-07-21 |