| NPI | 1184908477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: 4215) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OK 4215) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OK UNDER SUPERVISION) | |
| 101YP2500X Counselor Professional (Licence: OK 4215) | |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |