| NPI | 1164647681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 4988) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 4988) |
| 101YP2500X Counselor, Professional (Licence: NC 4988) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2025-10-02 |