| NPI | 1245463801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC PRC13862) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 2801) | 
| 101YP2500X Counselor, Professional (Licence: AZ LPC-15471) | |
| 101YP2500X Counselor, Professional (Licence: CO 2801) | |
| 101YP2500X Counselor, Professional (Licence: MD LC3413) | |
| 101YP2500X Counselor, Professional (Licence: TX 73681) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 2801) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DC PRC13862) | |
| 101YM0800X Counselor, Mental Health (Licence: DC PRC13862) | |
| Enumeration Date | 2009-08-31 | 
| Last Update Date | 2019-02-15 |