NPI | 1255733473 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0012585) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACD.0001037) |
Enumeration Date | 2014-09-18 |
Last Update Date | 2019-12-18 |