NPI | 1205350212 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 068.0134158) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 151.0129230) |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2017-08-01 |
Last Update Date | 2024-06-25 |