| NPI | 1225258718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA 008554) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA 1646-R) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2024-04-26 |