| NPI | 1235761677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL MH10323) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH10323) |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |