| NPI | 1295245793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LCPC-9690) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 11626) |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2024-04-15 |