| NPI | 1275970741 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 1275970741)  | 
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR 1639231715)  | 
| 101Y00000X Counselor (Licence: OR 323PO0000X)  | |
| Enumeration Date | 2013-05-24 | 
| Last Update Date | 2020-06-26 |