| NPI | 1164890224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401014603) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 2-01065) |
| Enumeration Date | 2015-09-07 |
| Last Update Date | 2019-08-27 |