| NPI | 1245734250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC8326) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD LC8326) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD AC2198) | |
| 101YP2500X Counselor Professional (Licence: MD LC8326) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2019-09-25 |