| NPI | 1194095968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 61348595) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1667) |
| 101YM0800X Counselor, Mental Health (Licence: MN cc01565) | |
| 101YM0800X Counselor, Mental Health (Licence: ND 847-8-1-15-304) | |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2022-12-11 |