| NPI | 1184117749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VT 068.0124899) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VT 151.0129115) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2022-04-09 |