| NPI | 1215533690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MS P1070) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MS AD18-015D) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 281135) | |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2024-04-30 |