NPI | 1295267979 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0016255) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0001217) |
Enumeration Date | 2017-03-31 |
Last Update Date | 2020-07-27 |