| NPI | 1215680020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL 17883) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 17883) |
| 101YM0800X Counselor, Mental Health (Licence: FL 17883) | |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2022-02-01 |