| NPI | 1164920591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701007474) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0701007474) |
| 101YM0800X Counselor, Mental Health (Licence: VA 0701007474) | |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2019-04-04 |