| NPI | 1245984996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 11434125) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 19426) |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2025-04-01 |