| NPI | 1174955371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 5683-125) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16950130) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2023-06-26 |