| NPI | 1235247164 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39001655A) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35001637A) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000759A) | |
| Enumeration Date | 2006-08-29 | 
| Last Update Date | 2013-05-03 |