| NPI | 1174753750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 624) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 3515) |
| 101YP2500X Counselor, Professional (Licence: NE 2050) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1063) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2016-08-30 |