| NPI | 1164163515 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 2704)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 1251)  | 
| Enumeration Date | 2022-04-07 | 
| Last Update Date | 2024-07-31 |