NPI | 1205319787 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0017694) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO NLC.0108279) |
Enumeration Date | 2018-09-11 |
Last Update Date | 2022-04-19 |