| NPI | 1205234549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 11293) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 3577) |
| 101YM0800X Counselor Mental Health (Licence: NC 11293) | |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2019-10-21 |