NPI | 1194078071 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 10739) |
Additional Taxonomies | 101Y00000X Counselor (Licence: 53372) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5303) | |
Enumeration Date | 2012-10-17 |
Last Update Date | 2012-10-17 |