| NPI | 1255931481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID 6380) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2481) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH14193) | |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |