| NPI | 1285627653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 450 LANC) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 2308 LMHP) |
| 101YM0800X Counselor, Mental Health (Licence: NE 1283 LPC) | |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2007-07-08 |