| NPI | 1245799964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: 88000803A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 88000803A) |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2020-10-05 |