| NPI | 1194312470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0019060) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2022-06-02 |