| NPI | 1174655732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 6503) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 3581) | |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2024-03-19 |