| NPI | 1245963016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC GRAN-L4K88C) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-27963) |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2022-07-07 |