NPI | 1235203563 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701003206) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000159) |
Enumeration Date | 2006-11-20 |
Last Update Date | 2023-10-30 |