| NPI | 1194332064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 16454) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC CADC-26755) |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2023-11-28 |