NPI | 1205977139 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DE PC-0000885) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 918) |
101YM0800X Counselor, Mental Health (Licence: MA LMHC5104) | |
Enumeration Date | 2007-02-12 |
Last Update Date | 2024-05-22 |