| NPI | 1245766070 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000889A) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39002020A) | 
| Enumeration Date | 2017-05-11 | 
| Last Update Date | 2017-05-11 |