| NPI | 1174776272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC005325) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C2225) |
| 101YP2500X Counselor, Professional (Licence: OR C2225) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA PC005325) | |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2011-08-01 |