| NPI | 1184069619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH18503) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 26032) |
| 101YM0800X Counselor, Mental Health (Licence: VT 068.0116999) | |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2021-01-21 |