| NPI | 1255726790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A11502) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC A11502) |
| 101YM0800X Counselor, Mental Health (Licence: NC A11502) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-21942) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2016-11-16 |