| NPI | 1265940696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO LPC.0017285) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACD.0001464) |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2025-03-17 |