| NPI | 1184643298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH8405) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN C-4514) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 507584) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2022-09-20 |