| NPI | 1245573849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 17200) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 270693) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health (Licence: VT 068.0135166TELE) | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2023-04-20 |