| NPI | 1215054119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NM 006079) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NM CAD0106251) |
| 101YM0800X Counselor Mental Health (Licence: NM CMH0198031) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2023-11-14 |