| NPI | 1215517156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701010285) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0701010285) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710101967) | |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2022-01-16 |