| NPI | 1306069596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 4859) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 4859) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 4859) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2010-05-19 |