| NPI | 1225503725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2021-07-15 |