| NPI | 1215473129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0701014240) |
| 101YM0800X Counselor, Mental Health (Licence: VA 0701014240) | |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2025-02-10 |