| NPI | 1255497178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY KY0057) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY KY0301) |
| 101YP2500X Counselor, Professional (Licence: MI MI6401004980) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2014-09-16 |