| NPI | 1164067070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A14765) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 26145) |
| 101YM0800X Counselor, Mental Health (Licence: NC A14765) | |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2020-06-03 |