| NPI | 1194909226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SD LPC20658) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 15R42) |
| 101YM0800X Counselor, Mental Health (Licence: OR C3923) | |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2020-06-22 |