| NPI | 1164791240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 9401) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2556) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2556A) | |
| 101YP2500X Counselor, Professional (Licence: NC 9401) | |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2023-02-14 |