| NPI | 1154848075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC7218) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC7218) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LC7218) | |
| 101YP2500X Counselor, Professional (Licence: MD LC7218) | |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2022-07-21 |