| NPI | 1245732379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 13127) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC A13127) |
| 101YP2500X Counselor Professional (Licence: NC A13127) | |
| 101Y00000X Counselor (Licence: NC A13127) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC A24539) | |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2021-03-01 |