| NPI | 1194201541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SD 20779) |
| 101YP2500X Counselor, Professional (Licence: ID 48724) | |
| 101YM0800X Counselor, Mental Health (Licence: FL 18725) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 15092) | |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2023-08-29 |