| NPI | 1205673431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA LMHC10003543) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: RI CDP00988) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2025-02-17 |