| NPI | 1205160199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2020024537) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CCMH0197151) |
| 101YM0800X Counselor, Mental Health (Licence: MO 2011041051) | |
| 101YM0800X Counselor, Mental Health (Licence: NC 7492) | |
| 101YM0800X Counselor, Mental Health (Licence: NM CCMH0197151) | |
| 101YP2500X Counselor, Professional (Licence: NM CCMH0197151) | |
| 106S00000X Behavior Technician (Licence: NM CCMH0197151) | |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2021-05-14 |